Red Hawk Comm-LR130329 Water Bacteriology Report / Chain of Custody Record
City of Lewisville Environmental Control Services Laboratory Samples Accepted Customer Comments: Ll t-i-l1'r' , Report#
LEWISVIT,LE 897 Treatment Plant Rd., Lewisville,TX 75057 Monday - Thursday
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Oaeprtoan. wtroan&Foe.a... Phone(972)219-3548 Fax(972)219-3506 8:00 A.M. - 12:00 Noon ` ► ti - "5-1-0- e`rr / —I;
Lab ID 48146 _ !1= t EPA Lab Code TX01143 . ` Sample Bottle
Customer Name: •ey 4-Lt. al-e4 / (Lvt, Protect Name: . r, ^e„x
•-E+1v c4L_ Project#
Customer Address:6X s ti/Ff R114.-e'R ;10. 2)- L 'j °» Project Address:G ( r r
Contact:
City,State,Zip pp� Li__ !1 5 , 1:- ? 'i G City,State,Zip Phone#
Phone# . d/4' Fax#-. Water System lD# d 0 C 4'
Sample Coil •on Inf7rmation ater Sampti nformation I . Analytical results
C y
/ o Type of Sample Water Total
/ Chlorine Results
Collected Source CO Coliform E.Coli T N al
Sample ID CA f .�Sample ID / Date Time d Q LI
(Lab Use Only) (Point of Collection " Collected Collected 3 a .x z c 3 E o a,
Z 2 a) it LAB Residual _ •i N a -0 -0 a E
d a Residual.. (mg/L) 2 To 2 Q o = m
Q
E a E w y v .o 'o
N t U > > 2 0 E. g m U) oj (J) I— u- H Q 0 (e c) o ' o o 0 0 0 0
RC- Z-1 A/ e G W n Cl)C L z z
, G W X
G W X
I G W X
G W X
G W l X
G W X
G W X
G W X
G W X
Sample Custody Documentation 9
Samplers Name:'� / #of Bottles Relinquished b
Print 1 Ci-w-R,D DEL4.: q y #of Bottles Date/
Collected Signature �,1�, q
Relinquished I Time _� �`��j 10 r(V,
Received By. ��r! #of Bottles Date/Time Relinquished By: #of Bottles Date/
Print 1 eN p !' Received Received Signature Relinquished Time
Received for Lab: ij/ i #of Bottles ,Date/Time ) Lab
Signature •'V° ^ Received Received - r Comments
t
Quality Control Data
Date/Time Analysis: Analytical Method: Sample ❑ Form Incomplete ❑Non-Coliform bacteria/silt present Approved By:
q 7 t 4, if idColilert TM(SM9223) Flags: ❑ Sample Outside Hold Time ❑Quantity too great to permit agitation "`+, (? 1� t
—. 1 Ix``33 MI SM 20th Edition \ •�
❑ Excessive Chlorine Present ❑Quantity insufficient for analy�� -•
❑ Unsuitable Container ❑
Sample Type(s): G-Grab; Sample Matrix: W-Water; Preservation: I-Samples Iced Down; Lab Chlorine Residual: ND-Not Detected, D-Dete..-• f.Thermometers/N:51030428
White(Original): Returned to Customer as a report/Chain of Custody record; Yellow: Customer Copy at time of drop off
,tYYcnw Water of satisfactory bacteriological quality should be free from Coliform organisms. as
"� Results above relate only to the samples on this report. `
ECSL certifies that all results contained in this report were produced in accordance with the requirements of NELAP unless otherwise noted.
Thi report is intended for the sole use of the customer for who the work was performed and must be reproduced,without modification,in its entirety.
Revision 1.5 7/31/2012 _ A � //! ! 0 �/A
Effective 7/31/2012 26Y? 1u VI r , ,/A rid t/(
Q is 1 -t K// (N/E ge 1 f 1 Bac-T Form